An economic analysis of robotic versus laparoscopic surgery for endometrial cancer: costs, charges and reimbursements to hospitals and professionals

Objective

To determine the actual costs, charges, and reimbursements associated with robotic vs. laparoscopic surgery for endometrial cancer.

Methods

Data were collected from hospital billing records, MD professional group billing records, tumor registry, and medical records on operations performed by a single surgeon from one institution between 2008 and 2010. For comparison, surgical groups were matched based on age, histology, and stage of disease over the same time period.

Results

Of 54 patients, 27 underwent robotic surgery (RS) and 27 had laparoscopic surgery (LS). The median age was 57 years. There were no statistically significant differences between the groups based on age, stage, and histology. The hospital charges for RS were higher at $64,266 vs. $55,130 for LS (p = 0.036). However, the reimbursement to the hospital was not statistically different at $13,003 for RS and $10,245 for LS (p = 0.29). Operating suite, room and board, anesthesia, post anesthesia care unit, and pathology accounted for over 90% of hospital charges. The surgeon charges for RS and LS were $6824 and $6327, respectively (p = 0.033) and the anesthesiologist charges were $4049 and $2985, respectively (p = 0.001). However, there were no differences in reimbursement to the surgeon (p = 0.74) and anesthesiologist (p = 0.84) between the two operative approaches.

Conclusions

Our data showed that the direct costs and charges associated with robotic surgery were higher compared to laparoscopic surgery. However, actual reimbursements to the hospital, surgeon, and anesthesiologist were not significantly different between the two surgical approaches.